August 1, 2009
By:Douglas Moeller, MD
Standardized medical policies, appropriate technology, centralized authorization tools can render a decision before the patient leaves the clinic
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August 1, 2009
By:Angela Boynton
The United Kingdom implemented ICD-10 as far back as 1995, making the United States one of the last major global economies to begin the implementation process.
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March 1, 2009
By:Dennis Schmuland, MD, FAAFP
Your competitive edge can come from digitizing and automating labor-intensive processes to gain efficiencies
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February 15, 2009
By:Tracey Walker
MCO execs should be looking at payment changes that are win-win for the payer, consumer
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October 15, 2008
By:Jill Wechsler
The proposed transition to ICD-10 and HIPAA 5010 will lead to chaos, fraud, abuse and consumer dissatisfaction because the current timeline is unworkable
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October 1, 2008
By:Blackford Middleton, MD, MPH, MSc
A successful health information exchange (HIE) must be constructed in a manner that accounts for and serves the needs of each stakeholder group individually and allows all, to share in the benefit. As a result, the success of a community-based HIE is as much a feat of cooperation as it is one of organization.
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April 1, 2008
By:Matthew Haddad
Professionals with problematic and tarnished credentials pose serious risk to healthcare consumers and create financial exposure – in the form of CMS fines -- for the institutions that unknowingly employ them. This black cloud now extends to health plans.
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April 1, 2008
By:Jill Wechsler
Despite widespread enthusiasm for establishing interoperative electronic health records, progress has been slow in developing the standards, protocols and rules needed to move from small initiatives to a national e-health system. To stimulate action, the Bush administration and major players in the e-health community are promoting electronic prescribing systems as an achievable step toward broader interconnectivity. Health plans and insurers are backing these efforts as a way to prevent medication errors and improve quality of care.
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February 1, 2007
By:Peter R. Kongstvedt, MD
The most significant pressures facing payers evolve constantly, though they rarely change radically from year to year. While payers strive to lower administrative costs and improve efficiencies, manage healthcare costs and grow the business, recent years have seen substantial change in how they address these issues.
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